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The Fierce Urgency Of The Mentally Ill

"Police arrested about two dozen people who barricaded themselves inside the Woodlawn Mental Health Clinic on the city's South Side to protest its planned closing," the Tribune reports.

"Of the 23 arrested, 12 were expected to be charged and 11 were released without charges, Chicago Police News Affairs Officer Hector Alfaro said.

"The outpatient clinic is one of six Mayor Rahm Emanuel has proposed closing, along with clinics in the Palmer Square, Rogers Park, Auburn Gresham, Back of the Yards and Morgan Park neighborhoods.

"Dozens of people, including the facility's patients, locked themselves inside the building by chaining doors shut and erecting barricades about 4 p.m. Thursday. Police cut through chains and started arresting people about 1 a.m."

The Twitter feed of Occupy Chicago provides an invaluable play-by-play from the inside, but this one summed up the general principle:

Perhaps Rahm could redefine mental health as infrastructure and include it in his new private bank.

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"According to the Chicago Tribune, some 5,100 patients receive services through the city's network of mental health clinics," Beth Bucynski writes at Care2 Causes. "About 3,000 are uninsured or underinsured, and another 2,100 carry Medicaid, Medicare or private insurance. The plan to close the clinics was made toward the end of 2011, and will save taxpayers about $3 million, according to the Chicago Department of Public Health.

"The City says it will refer the insured clients to nonprofit community mental health providers, but patients and their advocates have their doubts. Not to mention that thousands without insurance will be left to fend for themselves.

"The Mental Health Movement, which put out a report and a video undermining the Chicago Department of Public Health's claim that all patients will continue to receive care, has been calling for hearings on the clinic closures since October. Despite repeated promises and a resolution calling for hearings, the Emanuel Administration has prevented any hearings from taking place in order to avoid public scrutiny of the plan, which has come under fire even from Cook County Sheriff Tom Dart." (last two links added)

We have tried everything we could to be heard. We visited Mayor Emanuel when he was a candidate. We delivered him over 4,000 letters. We have talked to almost all 50 Alderman. We have held press conferences, rallies and even sat-in for 10 hours on the 5th floor of City Hall. We are the ones who know the disaster these clinic closures will mean for our communities and our city but Mayor Emanuel has been unwilling to listen to us, so we are taking drastic measures to avoid a tragedy and defend our human rights," says N'Dana Carter, who goes to one of the city clinics and is a spokesperson for the Mental Health Movement.

Where is Rahm's oft-proclaimed "fierce urgency of now" for these people? Or does that only apply when the fierce urgency of twisting policy to achieve political goals and blaming everyone else for getting in his way?

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On Tuesday, the American Federation of State, County and Municipal Employees sent this letter to the city council signed by 50 clinicians

We the undersigned believe the City of Chicago's Mental Health Centers should be preserved and strengthened. We base our belief on the following considerations:

Citizens of the City of Chicago are entitled to a continuation of reliable public health clinics that have been in place for decades, especially when private providers have sometimes been less reliable in providing consistent and affordable treatment.

This applies even more so in light of imminent State reductions in what Medicaid providers will be reimbursed for, assuming there are even providers accepting it.

We reject the glib recommendations of the Civic Federation that uninsured treatment recipients can just tough it out for two years at our understaffed clinics. At that point, arguably, they will all receive insurance under the Affordable Health Care Act. However, there are estimates that as many as 30% of low-income individuals will still not qualify.

We are disappointed that a meaningful debate on the value and viability of the City clinics has been prevented by Commissioner Choucair's narrative. He has repeatedly insisted that the closure of the clinics does not represent an initial stage toward privatization, despite unambiguous statements by the Civic Federation and Mayor Emanuel that the City need not provide clinical services that can be provided at a lower cost elsewhere.

There's something Orwellian in the assurance that decimating services will in fact enhance them. One deceptive example is the contention that closing six clinics and reducing the mental health budget by millions will magically "enhance service." Another is his insistence that the initiation of a Request for Proposals (RFP) will result in the delivery of $500,000 for psychiatric services, while omitting the reality that this is the first step toward the privatization of public employee jobs. An obvious question: Wouldn't it have been simpler to hire new psychiatrists instead of leaving psychiatric vacancies unfilled for two years?

When the Commissioner is repeatedly asked about the future of CDPH mental health clinics, he disingenuously says he has been consulting with partners and consumer advocates. When he told the City Council that the consolidation of the clinics was motivated by a desire to improve efficiency and effectiveness, he conveniently neglected to mention that the laying off of long-term experienced personnel would create overwhelming caseloads for the remaining clinicians, negating his assurance of improved services.

At a recent presentation, provided to Rogers Park residents at the request of Alderman Joe Moore, the Commissioner insisted a system-wide drop off in clinician productivity could be reversed by doubling or tripling the caseloads of remaining clinicians not scheduled for layoffs.

Unfortunately he omitted to mention that the productivity freefall was accelerated due to his passivity in filling psychiatric vacancies. He refused to follow the advice of the CDPH psychiatric staff to advertise in psychiatric journals and did nothing to alleviate the fear on the part of potential applicants that centers would soon be closing.

In hindsight it is easy to see that the center closings, the layoffs and the inability to hire psychiatrists constitute collateral damage, resulting from the implementation of the privatization of the CDPH clinics.

We believe the concerns and insights possessed by the members of the CDPH mental health staff have been intentionally dismissed and excluded from the Commissioner's narrative. It is time for the City Council and all concerned residents to stop taking at face value a single source regarding "quality mental health" in the City of Chicago.

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Another favorite:

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Closing clinics will cost us more on the back end. Where are Rahm's army of data geeks now?

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It's not just the city creating a crisis. The state, too, has found it easy to come up with bushels of dough to subsidize huge corporations while cutting the neediest loose.

"When I challenged state officials about the proposal to close Tinley Park Mental Health Center during a SouthtownStar editorial board meeting," Phil Kadner writes, "it became clear that they knew mental health patients weren't going to be getting better care [elsewhere, as claimed]."

Reminder: Rahm Emanuel and Pat Quinn are Democrats.

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Illinois No. 1 For Mental Health Care Budget Cuts.

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"State lawmakers again questioned the feasibility of closing the Tinley Park Mental Health Center and finding alternative services by July during a public hearing Tuesday on the state's latest plan to shutter the facility," the Tribune reports.

"You have some explaining to do and you're going to have to deal with the folks in these communities and sell them on it," said Rep. Al Riley, D-Hazel Crest. "This struggle continues."

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Comments welcome.



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Posted on April 13, 2012


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